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Trace metal release after minimally-invasive repair of pectus excavatum
Caroline Fortmann1, Thomas Göen2, Marcus Krüger3
1Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Background:
Several studies have shown a high incidence of metal allergy after minimally-invasive repair of pectus excavatum (MIRPE). We postulated that MIRPE is associated with a significant release of trace metal ions, possibly causing the allergic symptoms.
Methods:
We evaluated the concentration with chromium, cobalt and nickel in blood, urine and tissue in patients prior to MIRPE and in patients who underwent an explantation of the stainless-steel bar(s) after three years.
Results:
Our study group consisted of 20 patients (mean age 19 years) who had bar explantation and our control group included 20 patients (mean age 16 years) prior to MIRPE. At the time of bar removal we detected significantly elevated concentrations of chromium and nickel in the tissue compared to patients prior to the procedure (p<0,001). We also found a significant increase in the levels of chromium in urine and nickel in blood in patients three years post MIRPE (p<0,001). Four patients temporarily developed symptoms of metal allergy, all had elevated metal values in blood and urine at explantation.
Conclusions:
Minimally-invasive repair of pectus excavatum can lead to a significant trace metal exposure.
Insights
Minimally-invasive repair of pectus excavatum (MIRPE) can release significant trace metal ions, potentially causing metal allergies. This study found elevated chromium and nickel levels in patients after MIRPE.
Area of Science:
- Biomaterials Science
- Orthopedic Surgery
- Allergy and Immunology
Background:
- Minimally-invasive repair of pectus excavatum (MIRPE) is linked to a high incidence of metal allergy.
- The underlying cause may be significant release of trace metal ions during the procedure.
Purpose of the Study:
- To investigate the association between MIRPE and trace metal ion release.
- To evaluate chromium, cobalt, and nickel concentrations in patients undergoing MIRPE.
Main Methods:
- Blood, urine, and tissue samples were collected from patients before MIRPE and after three years.
- A control group of patients prior to MIRPE was included for comparison.
Main Results:
- Significantly elevated chromium and nickel concentrations were found in tissue at bar removal compared to pre-MIRPE.
- Increased levels of chromium in urine and nickel in blood were observed three years post-MIRPE.
- Four patients with temporary metal allergy symptoms showed elevated metal levels.
Conclusions:
- Minimally-invasive repair of pectus excavatum can lead to significant trace metal exposure.
- This exposure may contribute to the development of metal allergies in susceptible individuals.